RLE, PRK, LASIK, ICL or SMILE?

Which Vision Correction Procedure is the Best One for Me?

If you wear glasses or contact lenses for any activity and you’d like visual freedom, there are many excellent options available for you today.  Nearly everyone can reduce or eliminate their need for glasses with the modern surgical options for vision correction.   One of the vision correction procedures may be most suitable for a given patient.  How can you determine which is the best procedure for you?

To begin, let’s consider the various options that can lead to freedom from eyeglasses and contact lenses.

What is LASIK Eye Surgery?

Nearly everyone in North America has heard of LASIK as it is one of the most commonly performed procedures in the world.  LASIK is a modern vision correction procedure that involves the reshaping of the cornea with a laser.

LASIK begins with creation of a very thin flap in the clear tissue at the very front of the eye, called the cornea. After this flap is created with a laser or a device called a keratome, an excimer laser is used to reshape the cornea under the flap.  The computer programmed excimer laser will precisely flatten or steepen a patient’s cornea to change the corneal shape to correct the patient’s vision.

By far, LASIK is the most popular laser vision correction procedure performed today.  Typically, good candidates will be over 18 years of age, wearing eyeglasses or contacts, with healthy eyes, and a cornea that is of appropriate shape and thickness.   This procedure can correct the vast majority of prescriptions for nearsightedness, farsightedness, and astigmatism and is the ‘go to’ procedure for most patients.

Unfortunately, not everyone is a good candidate for LASIK.  Corneal diseases, thinner corneas, or large prescriptions are some reasons why a patient may not be a suitable candidate for LASIK.  LASIK has been performed for more than 20 years and it can provide permanent clear distance vision with 12-24 hours of the procedure.

Is PRK Different from LASIK?

PRK (Photorefractive keratectomy) is a modern laser vision correction procedure similar to LASIK which involves treating the surface of the cornea with the excimer laser. As such, there is no flap created in a PRK procedure.  The skin on the surface of the cornea is gently removed and the laser vision correction treatment is applied directly to the surface.

PRK is a highly effective, safe procedure with similar results to LASIK, but full recovery after PRK is a little slower because after PRK, the skin needs to heal over the surface of the eye.  Epithelial (skin) healing takes place over 3-4 days for most patients. Patients may choose PRK or they may be advised that PRK is a preferred procedure due to the presence of thinner corneas, corneal shape, or occupational considerations.  PRK can be a great procedure for anyone over age 18 with a stable correction and healthy eyes, but some patients may not be suitable for either LASIK or PRK.

Differing brand names for PRK techniques include LASEK, Advanced Surface Ablation, Surface Ablation, “No Touch” vision correction, and transepithelial PRK.  Each of these names describe the surface laser vision correction procedure commonly known as PRK. PRK has been performed for more than 25 years.  With newer eye tracing lasers, both PRK and LASIK can correct nearsightedness, farsightedness, and astigmatism.  Approximately 15% of US laser vision correction procedures are PRK procedures.

What is an ICL?

An implantable contact lens or ICL is another option to correct the vision for patients who are dependent on glasses or contact lenses. In an ICL procedure, a small soft lens (the implantable contact lens) is inserted into the eye where it rests behind the colored part of the eye called the iris, right in front of the patient’s natural lens.  An ICL is very similar to a contact lens and it is FDA approved to correct nearsightedness and astigmatism.  ICLs are a great choice for patients with large corrections or those with very thin corneas who may not be suitable for LASIK or PRK.  To be suitable for an ICL, patients should be under 40-45 years of age, with healthy eyes.  A preoperative eye exam will determine if the size of the patient’s eye is appropriate for ICL placement.  Recovery is typically 1-2 days for most patients.

 

What is Refractive Lens Exchange?

A refractive lens exchange, also referred to as an RLE, is a permanent vision correction solution that can correct the need for both distance vision glasses and reading glasses.  During an RLE procedure, the surgeon will remove the natural lens inside the patient’s eye and replace it with a custom selected lens implant.   This procedure can be an excellent option for patients who are 45 or older and who wish for clear distance vision and good reading vision without the need for reading glasses. Because most people who are younger than 45 do not need reading glasses, a RLE procedure may become more attractive as patients age through their late 40’s or 50’s. RLE is often a preferred option for patients who are over age 60-65 who have healthy eyes because after a RLE procedure, a patient will never develop a cataract.  Depending on a patient’s prescription, visual goals, corneal shape and thickness, and age, an RLE can be an outstanding and highly effective permanent procedure to provide a lifetime of clear vision.

Is SMILE better than LASIK?

An uncommonly performed procedure known as SMILE involves the use of a laser to create a thin layer of corneal tissue that is manually removed through an incision with forceps by the surgeon.  This technique can correct some prescriptions, but as LASIK is so safe, effective, and comfortable, SMILE is likely to remain an interesting application of a laser with little, if any advantage over LASIK.  Most refractive surgeons find LASIK to be the most comfortable, safe, and effective means to correct the vision for patients who are dependent on glasses or contact lenses for clear distance vision, but PRK, ICLs, RLEs are all great options for the right patients.

How do I Pick the Best Vision Correction Procedure for Me?

The first step to determine the best procedure for you would be a full eye exam, testing and a consultation with a vision correction surgeon.  Most ophthalmologists do not offer the full range of vision correction options so be sure to consult with a center that offers LASIK, PRK, ICLs, and RLEs.  Regardless of your age or visual goals, it is highly likely that there is a solution for you.  Financing options can make vision correction surgery affordable and more economical than continued use of inconvenient glasses or contact lenses.

The first step to visual freedom is a consultation. Click here to schedule a free consultation at King LASIK: